Assessment of phlebotomy errors by direct observation of sample collection procedure in a NABL Accredited Hospital: An Observational study

Abstract

Background: Preanalytical phase is largely dependent on phlebotomist. The most frequently encountered preanalytical errors are hemolysis, incorrect patient identification, clotted specimens and insufficient sample volume. These errors can mostly be attributed to faulty phlebotomy procedure. Objective: To assess phlebotomy errors by direct observation of laboratory professionals-patients interaction during phlebotomy procedure. Material and methods: This study used the real time observations of patient-laboratory staff interactions to collect first-hand data on phlebotomy errors. Five different phlebotomists were directly observed while performing phlebotomy procedure on 200 patients. A checklist was used to collect data on the phlebotomy procedure and errors. Results: During the observation period, 200 blood samples were drawn into 457 tubes by 5 phlebotomists and none of the procedures could meet all the quality criteria of good and safe phlebotomy practice as described by WHO. Conclusion: There is urgent need for standard operating protocols to standardize phlebotomist-patient interaction. Phlebotomy errors can damage the institution's reputation, diminish confidence in healthcare services and contribute to increase in total operating costs, both for the hospital and laboratory. While it is understood that human errors cannot be completely eliminated, compliance with best practices for blood collection may help in minimizing the errors.

Keywords

• preanalytical phase
• laboratory professionals
• phlebotomy
• hemolysis